Since the notification of the existence and quick spread of the novel coronavirus SARS-CoV-2 in Mexico, the organization and implementation of hospital conversion in the country’s Health National System has been instrumental in facing this emergency, as well as maximizing the nation’s attention and facing the pressures of COVID-19 cases (10–12).
For the health crisis, it was considered necessary to enlist the participation of health workers in their last years of education, assigning them to non-COVID-19 hospitals, in order to discharge their academic and social functions (13). In this context, the strategies implemented were essential to fulfilling the demand that emerged in this situation, as well as to enable the health workers to complete their education efficiently (14).
The deficit of information provided by the academic institutions and the health sector, together with the lack of timely and efficient training about COVID-19 have seemed to mediate insecure behaviors, affecting not only the effective prevention measures but also the effectiveness of measures to lower the rate of infected people (15). Importantly high scores in knowledge tests about COVID-19 were significantly associated with a lower probability of negative attitudes and potentially dangerous practices to face the COVID-19 epidemic (16).
The COVID-19 virus has had a worldwide impact directly on the physical and mental health of millions of people (17). The COVID-19 pandemic has caused a generalized climate of caution, uncertainty, and stress, due to a wide variety of causes, particularly among health professionals (18) as we describe here.
The most recognized reported factors in our survey are the concern about the lack of personal protection equipment, exhaustion, worries about not being able to provide competent care if the disease extends to new areas, concerns about the scientific and clinical information that changes quickly, lack of access to information and up-to-date communications, the absence of specific medications, the shortage of ventilators and beds in the intensive care unit to address the emerging of critically ill patients, and a significant change in their social and family life plus education / training (19).
Around the world, there have been studied different surveys to understand and observe the behavior of health workers while facing the COVID-19 pandemic. Most of the studies in Latin America concluded that the surveyed health personnel feel uncertainty, fear, and anguish, but also there emerged a feeling of responsibility and a wish to face COVID-19 (20). This accords with our findings as described.
Among these large scale surveys to health personnel, there stand out concerns about lack of institutional resources and availability of personal protection equipment. There are concerns about government measures like the absence of strategies of containment for the health workers and clear and standardized institutional communication, together with disquiet about creation of the necessary conditions to face the pandemic, access to information, and lack of integration among the subsectors of the system (21). Added to this, there are negative or neutral valuations of their participation as health personnel in this health emergency.
This study shows evidence that the health workers in training, who have experienced conflicts in their professional practice because of the COVID-19 pandemic, agree that the personal protection equipment and inputs are not enough. Despite having been placed in lower-risk areas, the social service intern doctors were assigned to biologically dangerous tasks, not having the appropriate equipment. This reinforces the feelings of fear, anger, sadness, distrust, and repulsion, which causes interpersonal conflicts with their coworkers, generating negative perceptions of their professional development and the need for continuous education, as implemented in other countries (22).
The role played by e-learning, especially the educational platforms is important in these situations. Nevertheless, there still is a significant gap in the facility of this kind of teaching to enable the development of abilities and skills that this kind of emergency requires.
Knowing the insights of the health personnel is important in order to be able to generate community awareness and to develop the necessary social discipline to face the COVID-19 epidemic. As in other places in the world, there is annoyance and physical, social, emotional, and mental exhaustion in the health workers, which impacts directly on their personal and professional development.
We suggest the following interventions in the light of the findings in this survey
An action plan and continuity plan for the education of the health care personnel in training, facing emergencies and disasters by the education authorities of medical units, in which there are established the instructions and functions that the health personnel in training must perform, as well as the necessary provisions that the recipient unit considers about the material, personal protection equipment, training, etc.
To develop these guidelines based on the experience of the COVID-19 pandemic.
Interventions like timely information through the use of information technology (IT), mentoring by qualified and experienced personnel and support in the self-education material by the Educational Institutions.
Protection of the safety of undergraduate intern doctors and practitioners, and the deployment of training actions during the confinement, as well as a controlled plan of reincorporation once the emergency is over.
The need for psychological and social attention to human resources in training. The offering of psychological support could be made through helplines and chats in the different health services of each state and through the “Capas” or Psychological Attention Centres.